Ophthalmology Book

Anatomy

Corneal Disorders

Eyelid Disorders

Glaucoma

Lacrimal Disorders

Miscellaneous

Pediatrics

Pupil Disorders

Retinal Disorders

Sclera Disorders

Traumatic Injury

Vision Disorders

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Pupil

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  1. Physiology
    1. Variable sized circular hole in pigmented iris
    2. Hole size controlled by 2 muscles
      1. Sphincter pupillae
        1. Circular muscle constricts pupil (Miosis)
        2. Parasympathetic from Edinger-Westphal near CN3
      2. Dilator pupillae
        1. Radial muscle dilates pupil (Mydriasis)
        2. Sympathetic via:
          1. Hypothalamus
          2. Ciliospinal center of Budge and Waller
  2. Pupil size changes
    1. Pupil constriction (Miosis)
    2. Pupil Dilation (Mydriasis)
  3. Pupil distortion
    1. Posterior synechiae
      1. Inflammatory adhesion between lens and iris
    2. Tear drop-shaped pupil
      1. Suggests Globe Rupture with iris prolapse
  4. Pupil fixed, mid-dilated, slightly irregular
    1. Acute Glaucoma
  5. Pupil Normal in
    1. Conjunctivitis
  6. Absent Pupillary Light Reflex
    1. Structural lesion
    2. Hypothermia
    3. Barbiturate or Opiate overdose

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